作者：张春芳，金旭，顾权，杨科

单位：

100013北京市和平里医院急诊科

Units：

Emergency Department, Beijing Hepingli Hospital, Beijing 100013, China

关键词：

脑缺血发作，短暂性；脑梗死；补体1q；载脂蛋白B；载脂蛋白A1；预测

Keywords：

Ischemic attack, transient; Brain infarction; Complement 1q; Apolipoprotein B;Apolipoprotein A1;Forecasting

CLC：

R 743.31　R 743.33

DOI：

10.12114/j.issn.1008-5971.2022.00.166

Funds：

北京市自然科学基金资助项目（7184258）

摘要：

目的　探讨血清补体1q（C1q）联合载脂蛋白（Apo）B/ApoA1比值对短暂性脑缺血发作（TIA）患者发生脑梗死的预测价值。方法　选取2019年1月至2021年1月北京市和平里医院急诊科收治的TIA患者108例，根据TIA后1个月内是否发生脑梗死将其分为梗死组（n=31）和对照组（n=77）。比较两组患者实验室检查指标，TIA患者血清C1q与ApoB/ApoA1比值的相关性分析采用Pearson相关分析，绘制ROC曲线以评价血清C1q、ApoB/ApoA1比值及二者联合（并联）对TIA患者发生脑梗死的预测价值。结果　梗死组患者血清C1q、ApoB/ApoA1比值及同型半胱氨酸（Hcy）、载脂蛋白（a）〔Lp（a）〕、TC、LDL、TG、超敏C反应蛋白（hs-CRP）高于对照组，HDL低于对照组（P ＜0.05）。Pearson相关分析结果显示，TIA患者血清C1q与ApoB/ApoA1比值呈正相关（r =0.210，P =0.029）。ROC曲线分析结果显示，血清C1q、ApoB/ApoA1比值及二者联合预测TIA患者发生脑梗死的AUC分别为0.837〔95%CI（0.757，0.918）〕、0.802〔95%CI （0.718，0.886）〕、0.910〔95%CI （0.857，0.962）〕，二者联合预测TIA患者发生脑梗死的AUC分别大于血清C1q、ApoB/ApoA1比值单独预测TIA患者发生脑梗死的AUC（P ＜0.05）。结论　TIA患者血清C1q与ApoB/ApoA1比值呈正相关，血清C1q联合ApoB/ApoA1比值对TIA患者发生脑梗死的预测价值较高，可能作为TIA病情监测及脑梗死风险评估的生物学指标。

Abstract：

Objective　To explore the predictive value of serum complement 1q (C1q) combined with ratio ofapolipoprotein (Apo) B/ApoA1 for brain infarction in patients with transient ischemic attack (TIA) . Methods　A total of 108patients with TIA treated in the Emergency Department of Beijing Hepingli Hospital from January 2019 to January 2021 wereselected. According to whether they had brain infarction within 1 month after TIA，they were divided into infarction group (n=31)and control group (n=77) . The laboratory examination indexes were compared between the two groups. Pearson correlation analysiswas used to analyze the relationship between serum C1q and ratio of ApoB/ApoA1 in patients with TIA, and ROC curve was drawnto evaluate the predictive value of serum C1q, ratio of ApoB/ApoA1 and their combination for brain infarction in patients with TIA.Results　The serum C1q, ratio of ApoB/ApoA1, and homocysteine (Hcy) , apolipoprotein (a) [Lp (a) ] , TC, LDL, TG and highsensitivityC-reactive protein (hs-CRP) in the infarction group were higher than those in the control group, and HDL was lowerthan that in the control group (P < 0.05) . Pearson correlation analysis result showed that serum C1q was positively correlated withratio of ApoB/ApoA1 in patients with TIA (r =0.210, P =0.029) . ROC curve analysis showed that the AUC of serum C1q, ratio ofApoB/ApoA1 and their combination in predicting brain infarction in patients with TIA were 0.837 [95%CI (0.757, 0.918) ] , 0.802[95%CI (0.718, 0.886) ] , 0.910 [95%CI (0.857, 0.962) ] , respectively. The AUC of their combination in predicting brain infarctionin patients with TIA was higher than that serum C1q, ratio of ApoB/ApoA1 in predicting brain infarction in patients with TIA (P< 0.05) . Conclusion　Serum C1q is positively correlated with ratio of ApoB/ApoA1 in patients with TIA. Serum C1q combinedwith ratio of ApoB/ApoA1 has high predictive value for brain infarction in patients with TIA, and they may be used as biologicalindexes for condition monitoring and risk assessment of brain infarction in patients with TIA.

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